Division of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
Pediatr Radiol. 2021 Mar;51(3):353-370. doi: 10.1007/s00247-020-04794-y. Epub 2020 Oct 7.
Neurosonography is an essential imaging modality for assessing the neonatal brain, particularly as a screening tool to evaluate intracranial hemorrhage, hydrocephalus and periventricular leukomalacia. The primary advantages of neurosonography include portability, accessibility and lack of ionizing radiation. Its main limitations are intrinsic operator dependence and the need for an open fontanelle. Neurosonographic imaging acquisition is typically performed by placing a sector transducer over the anterior fontanelle and following sagittal and coronal sweeps. The sensitivity of neurosonography has markedly improved thanks to the adoption of modern imaging equipment, the use of dedicated head probes, and the employment of advanced diagnostic US techniques. These developments have facilitated more descriptive identification of specific cerebral anatomical details, improving understanding of the cerebral anatomy by conventional US. Such knowledge is fundamental for enhanced diagnostic sensitivity and is a key to understanding pathological states. Furthermore, familiarity with normal anatomy is crucial for understanding pathological states. Our primary goal in this review was to supplement these technological developments with a roadmap to the cerebral landscape. We accomplish this by presenting a systematic approach to using routine US for consistent identification of the most crucial cerebral landmarks, reviewing their relationship with adjacent structures, and briefly describing their primary function.
神经超声是评估新生儿脑的重要成像方式,特别是作为评估颅内出血、脑积水和脑室周围白质软化症的筛查工具。神经超声的主要优点包括便携性、可及性和无电离辐射。其主要局限性是固有操作人员依赖性和需要开放囟门。神经超声成像采集通常通过将扇形换能器放置在前囟门上,并进行矢状和冠状扫描来完成。由于采用了现代成像设备、专用探头以及先进的诊断性超声技术,神经超声的敏感性有了显著提高。这些发展促进了对特定大脑解剖细节的更具描述性的识别,从而提高了对常规 US 大脑解剖结构的理解。这种知识对于提高诊断敏感性至关重要,也是理解病理状态的关键。此外,熟悉正常解剖结构对于理解病理状态至关重要。我们在本次综述中的主要目标是通过提供大脑景观图来补充这些技术发展。我们通过提出一种系统的方法来使用常规 US 来一致地识别最重要的大脑地标,审查它们与相邻结构的关系,并简要描述它们的主要功能来实现这一目标。